Hemodynamic Effects and Pharmacokinetics of Long-Term Therapy with Ibopamine in Patients with Chronic Heart Failure

Itoh, Hideshi; Taniguchi, K.; Tsujibayashi, Takashi; Koike, Atsushi; Sato, Yu; Nakamura, Suguru

doi:10.1159/000175026

Cited by 8 publications

(6 citation statements)

References 12 publications

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“…This hypothesis has been supported by an invasive study examining the changes in myocardial mechanics produced by plasma epinine concentrations comparable to those achieved after administration of therapeutic oral doses of ibopamine (l00 to 200mg) [Rousseau et al 1992]. Haemodynamic effects of oral ibopamine, administered as a single dose in patients at rest with moderate to severe congestive heart failure Reference De Vita et al (1986) Dei Cas et al (1992) Oi Mario et al (1990) Green et al Itoh et al (1992) Metra et al Morimoto et al (1989) Reffoetal. Haemodynamic effects of oral ibopamine, administered as a single dose in patients at rest with moderate to severe congestive heart failure Reference De Vita et al (1986) Dei Cas et al (1992) Oi Mario et al (1990) Green et al Itoh et al (1992) Metra et al Morimoto et al (1989) Reffoetal.…”

Section: Central Haemodynamic Effectsmentioning

confidence: 93%

“…Many studies have shown ibopamine to have no significant proarrhythmic activity (Dei Cas et al 1988;Fazio et al 1990;Fonseca et al 1989;Man in' t Veld 1990;van Veldhuisen et al 1990a), although some studies have reported an increase in premature ventricular contractions and arrhythmia in small numbers of patients (n = 1 to 5) during ibopamine therapy Cavalli et al 1989;Ghiringhelli et al 1990;Itoh et al 1992;Kayanakis et al 1991;Partanen et al 1988). However, in 2 of these trials, ventricular arrhythmia was present in most patients at baseline Ghiringhelli et al 1990).…”

Section: Tolerabilitymentioning

confidence: 99%

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Ibopamine

Spencer¹,

Faulds²,

Fitton³

1993

Drugs & Aging

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Ibopamine is an orally administered dopamine agonist which is rapidly converted to its active metabolite epinine by esterase hydrolysis. Ibopamine acts predominantly as a vasodilator and inhibitor of neuroendocrine activation in congestive heart failure, but also has mild positive inotropic effects at higher doses. The beneficial effects on cardiac and systemic haemodynamic parameters seen in short term studies have been maintained in predominantly noncomparative trials for up to 1 year, and improvements in New York Heart Association (NYHA) functional class and clinical symptoms have been observed in patients with congestive heart failure of varying severity. In double-blind studies conducted in small numbers of patients, the efficacy of ibopamine was comparable to that of digoxin, captopril, enalapril and hydrochlorothiazide. Ibopamine can successfully replace treatment with intravenous dopamine in patients with severe heart failure, and is effective and well tolerated when administered in combination with digoxin, diuretics and/or angiotensin converting enzyme (ACE) inhibitors. Ibopamine has shown no detrimental effects on renal function, few adverse effects on neurohormonal parameters and has demonstrated no significant proarrhythmic properties at therapeutic doses in patients with congestive heart failure. No adverse metabolic effects were observed during ibopamine therapy in patients with diabetes mellitus, nor did ibopamine have detrimental effects in patients with chronic obstructive pulmonary disease. While reliable evidence is required concerning effects on mortality before the role of ibopamine can be clearly defined, the drug appears to be a useful agent for combination with conventional therapies in treating patients with mild to severe congestive heart failure.

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Section: Central Haemodynamic Effectsmentioning

confidence: 93%

Section: Tolerabilitymentioning

confidence: 99%

Ibopamine

Spencer¹,

Faulds²,

Fitton³

1993

Drugs & Aging

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“…At a systemic level, low-dosage ibopamine does not affect the arterial pressure during either the short or the long term [33,35,36]. In our study no significant pressure differences were found between the two groups during the observation period.…”

Section: Discussionmentioning

confidence: 49%

Low-Dosage Ibopamine Treatment in Progressive Renal Failure: A Long-Term Multicentre Trial

Stefoni

Mosconi²,

Manna³

et al. 1996

Am J Nephrol

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A multicentre trial (11 nephrology centres) was carried out to test the effects of ibopamine, an orally active dopamine-like drug, on the progression of chronic renal failure. For a 2-year period 189 chronic renal failure patients (serum creatinine level 1.5-4.0 mg/dl) were observed. They were homogeneous for basic nephropathy, degree of residual renal function, blood pressure, and proteinuria. the patients were randomly divided into two groups: 96 took ibopamine at a dosage of 100 mg/day (group A) and 93 served as controls (group B). All were on a low-protein diet (mean 0.8 g/kg body weight). By the end of the observation period, the rate of decrease of the renal function indexes in time proved significantly slower (1.8 times) in group A than in group B. The survival curves for renal function (pre-established end points were creatinine level increases equal to or > 20% and equal to or > 40% of the basal values) proved significantly better (p < 0.02 and p < 0.002 respectively) in group A than in group B. The mean plasma creatinine values rose by 17% in group A and by 36% in group B. The creatinine clearance decreased by 5% in treated patients and by 14% in the controls. Statistical analysis ruled out any possible centre effect. The trial suggests that low-dosage ibopamine administration may be used as a valid and safe pharmacological adjunct for retarding the progression of renal failure in patients with mild or moderate chronic renal impairment.

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“…Ibopamine is an orally active dopamine agonist which has been shown to activate dopaminergic receptors DA1 and DA2 at daily doses of 100-200 mg, β-adrenergic receptors at 300-400 mg, and α-adrenergic receptors at greater than 400 mg. 6,7 Its pharmacological effect is maintained over prolonged periods. 8,9 Both in normal subjects and in patients with mild renal impairment, ibopamine administration has produced an increase in renal plasma flow, an increase in 99m Tc-DTPA clearance, a reduction in filtration fraction and an increase in sodium excretion and diuresis. [10][11][12] Stefoni et al 2 conducted a prospective, randomised, open-label, multicentre trial of ibopamine in patients with mild-to-moderate chronic kidney disease CKD (plasma creatinine 1.5-4.0 mg/dL).…”

Section: Ibopaminementioning

confidence: 99%

“…The latter point may be particularly relevant since ibopamine has been shown to exert an antagonistic effect against angiotensin II at both a glomerular and tubular level. 8,13 It also directly reduces activation of the renin-angiotensin system and inhibits aldosterone secretion. [14][15][16] Three prospective, non-controlled, small studies by single centres [3][4][5] have reported a significant improvement in renal function indices (plasma creatinine, reciprocal plasma creatinine or creatinine clearance) in patients with mild-tomoderate CKD treated with ibopamine 100 mg daily for periods ranging from 6 to 24 months.…”

Section: Ibopaminementioning

confidence: 99%

Other agents

Johnson¹

2006

Nephrology

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Suggestions based on level III and IV sources)• There is limited evidence to suggest that the progression of certain forms of renal disease is retarded by nonsteroidal anti-inflammatory drugs (NSAIDs), (Level III evidence; several retrospective and prospective cohort studies; mostly surrogate outcome measures; consistent weak effect) and by combined ketaconazole and prednisone (Level II-III evidence; single small cross-over study; clinically relevant outcome; weak effect). However, these benefits are outweighed by the serious side-effects of these medications and their use cannot be currently recommended. BACKGROUND

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Hemodynamic Effects and Pharmacokinetics of Long-Term Therapy with Ibopamine in Patients with Chronic Heart Failure

Cited by 8 publications

References 12 publications

Ibopamine

Ibopamine

Low-Dosage Ibopamine Treatment in Progressive Renal Failure: A Long-Term Multicentre Trial

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